Summary
Insomnia summary
- Course
- Institution
In depth question summary of insomnia and drugs prescribed for it
[Show more]
Seller
Follow
rosiemalley
Reviews received
Content preview
InsomniaCauses of insomnia
drugs
life events
environment
illness
increased age
increased daytime napping
chronic: anxiety, depression
What is the sleep cycle? Stages
- NREM 1: transition between wakefulness and sleep, 10mins
- NREM 2: body temp drops, HR slows, brain produces sleep spindles, 20mins
- NREM 3: muscles relax, bp and breathing rate drops, deepest sleep
- REM sleep: brain becomes more active, body relaxed, immobolised, dreams occur,
eyes move rapidly
Why does older age cause more insomnia?
- Spend more time in NREM1 and NREM 2
o More easily woken as not as deep sleep
- Weakened bladder
- Pain and breathing waking you up
What controls the sleep cycle?
- Melatonin and adenosine
- Adenosine builds up across the day making us sleepy
- Melatonin builds up in the evening and helps us remain asleep
- Diminishes in the morning
What happens to melatonin in the elderly?
- Melatonin peaks earlier and diminishes sooner
Types of insomnia
Transient
- Jet lag
- Work shift
- Short term
- Sleep well usually
Acute
- A few weeks
- Bereavement
- Physical illness
Chronic
- Long term
- At least 3 days a week
- For 3 months
- Right environment to sleep but still cant
- Having adverse daily issues
When should you refer a patient with insomnia?
- Snoring heavily
- Restless legs
- Mental health associated
, - Under 16
Routine advice to treat insomnia
- Sleep diaries
- Increased daily exercise
- Stop naps
- Bedroom light and noise minimum
- Reduce alcohol, fluids, chocolate, smoking and caffeine at night
o Caffeine after midday
o Smoking 6 hours before bed
o Fluid and food 3 hours before bed
- Relaxation audio tools
- If you can’t sleep for 30 mins get up and do something else
- Keep pets outside the bedroom
- CBTi
- Sleepio app
Effect of alcohol on sleep cycle
- Disrupts circadian function
- Increased toilet use at night
- More time in NREM1 than NREM2
- Makes you snore disturbing sleep
Pharmacological treatment for insomnia
Severe acute insomnia
- BZDs and Z drugs
- No difference in terms of efficacy
- Shortest time [period
- Usually 2 weeks max 4
- Lowest effective dose
Find and treat underlying cause
Prescribing advice for insomnia
- Risks outweight beenfits
- Prescribe lowest acquisition cost
- Reduce dose slowly if patients have used hypnotics for prolonged period
- Additive sedative effects with alcohol and other sedating drugs e.g. clozapine
o So, inform patient
What are some short-acting agents for insomnia?
- Temazepam
- Zolpidem
- Works within an hour and lasts 2-3 hours
- Helps for those who have difficulty falling asleep
- Increased risk of tolerance
What are long-acting agents for insomnia?
- Nitrazepam and zopiclone
- Takes a couple of hours to work
- Lasts 5-6 hours
- Frequent early morning waking patients
- Mindful of next day sedation and loss of co-ordination
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller rosiemalley. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $3.86. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72042 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now